Skip to main content
SpringerLink
Log in

Brief Report: Prevalence of Self-injurious Behaviors among Children with Autism Spectrum Disorder—A Population-Based Study

  • Brief Report
  • Published:
Journal of Autism and Developmental Disorders Aims and scope Submit manuscript

Abstract

Self-injurious behaviors (SIB) have been reported in more than 30 % of children with an autism spectrum disorder (ASD) in clinic-based studies. This study estimated the prevalence of SIB in a large population-based sample of children with ASD in the United States. A total of 8065 children who met the surveillance case definition for ASD in the Autism and Developmental Disabilities Monitoring (ADDM) Network during the 2000, 2006, and 2008 surveillance years were included. The presence of SIB was reported from available health and/or educational records by an expert clinician in ADDM Network. SIB prevalence averaged 27.7 % across all sites and surveillance years, with some variation between sites. Clinicians should inquire about SIB during assessments of children with ASD.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  • American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: American Psychiatric Publishing.

    Google Scholar 

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: American Psychiatric Publishing.

    Book  Google Scholar 

  • Ando, H., & Yoshimura, I. (1979). Comprehension skill levels and prevalence of maladaptive behaviors in autistic and mentally retarded children. Child Psychiatry and Human Development, 9, 131–136.

    Article  PubMed  Google Scholar 

  • Baghdadli, A., Grisi, C., & Aussillloux, C. (2003). Risk factors for self-injurious behaviors among 222 young children with autistic disorders. Journal of Intellectual Disability Research, 47, 622–627.

    Article  PubMed  Google Scholar 

  • Bickel, J., Bridgemohan, C., Sideridis, G., & Huntington, N. (2015). Child and family characteristics associated with age of diagnosis of an autism spectrum disorder in a tertiary care setting. Journal of Developmental Behavioral Pediatrics, 36, 1–7.

    Article  PubMed  Google Scholar 

  • Buono, S., Scanella, P., & Palmigiano, M. (2010). Self-injurious behavior: A comparison between Prader–Willi Syndrome, Down Syndrome and Autism. Life Span and Disability, 2, 187–201.

    Google Scholar 

  • Centers for Disease Control and Prevention. (2007). Prevalence of autism spectrum disorders: Autism and developmental disabilities monitoring network, 6 sites, 2000. Mortality Morbidity Weekly Report Surveillance Summaries, 56, 1–20.

    Google Scholar 

  • Centers for Disease Control and Prevention. (2009). Prevalence of autism spectrum disorders: Autism and developmental disabilities monitoring network, 14 sites, 2006. Mortality Morbidity Weekly Report Surveillance Summaries, 58, 1–20.

    Google Scholar 

  • Centers for Disease Control and Prevention. (2012). Prevalence of autism spectrum disorders: Autism and developmental disabilities monitoring network, 11 sites, 2008. Mortality Morbidity Weekly Report Surveillance Summaries, 61, 1–19.

    Google Scholar 

  • Centers for Disease Control and Prevention. (2014). Prevalence of autism spectrum disorders among children aged 8 years: Autism and developmental disabilities monitoring network, 11 sites, United States, 2010. Mortality Morbidity Weekly Report Surveillance Summaries, 63, 1–21.

    Google Scholar 

  • Centers for Disease Control and Prevention. (2016). Prevalence of autism spectrum disorders among children aged 8 years: Autism and developmental disabilities monitoring network, 11 sites, United States, 2012. Mortality Morbidity Weekly Report Surveillance Summaries, 65, 1–28.

    Google Scholar 

  • Devine, D. (2014). Self-injurious behaviors in autistic children: A neuro-developmental theory of social and environment isolation. Psychopharmacology (Berl), 231, 979–997.

    Article  Google Scholar 

  • Dominick, K., Davis, N., Lainhart, J., Tager-Flusberg, H., & Folstein, S. (2007). Atypical behaviors in children with autism and children with language impairment. Research in Developmental Disabilities, 28, 145–162.

    Article  PubMed  Google Scholar 

  • Duerden, E., Oakley, H., Mak-Fan, K., McGrath, P., Taylor, M., et al. (2012). Risk factors associated with self-injurious behaviors in children and adolescents with autism spectrum disorders. Journal of Autism and Developmental Disorders, 42, 2460–2470.

    Article  PubMed  Google Scholar 

  • Emerson, E., Kiernan, C., Alborz, A., Reeves, D., Mason, H., Swarbrick, R., et al. (2001). The prevalence of challenging behaviors: A total population study. Research in Developmental Disabilities, 22, 77–93.

    Article  PubMed  Google Scholar 

  • Esbensen, A., Seltzer, M. M., Lam, K. S., & Bodfish, J. W. (2009). Age-related differences in restricted repetitive behaviors in autism spectrum disorders. Journal of Autism and Developmental Disorders, 39, 57–66.

    Article  PubMed  Google Scholar 

  • Fee, V. E., & Matson, J. L. (1992). Definition, classification, and taxonomy. In J. K. Luiselli, J. L. Matson, & N. Singh (Eds.), Self-injurious behavior: Analysis, assessment, and treatment (pp. 3–20). New York: Springer.

    Chapter  Google Scholar 

  • Guinchat, V., Cravero, C., Diaz, L., Perisse, D., Xavier, J., et al. (2015). Acute behavioral crises in psychiatric inpatients with autism spectrum disorder: Recognition of concomitant medical and non-ASD psychiatric conditions predicts enhanced improvement. Research in Developmental Disabilities, 38, 242–255.

    Article  PubMed  Google Scholar 

  • Iannuzzi, D., Cheng, E., Broder-Fingert, S., & Bauman, M. (2015). Emergency department utilization by individuals with autism. Journal of Autism and Developmental Disorders, 45, 1096–1102.

    Article  PubMed  Google Scholar 

  • Kalb, L. G., Stuart, E., Freedman, B., Zablotsky, B., & Vasa, R. (2012). Psychiatric-related emergency department visits among children with an autism spectrum disorder. Pediatric Emergency Care, 28, 1269–1275.

    Article  PubMed  Google Scholar 

  • Lance, E., York, J., Lee, L. C., & Zimmerman, A. W. (2014). Association between regression and self-injurious behaviors among children with ASD. Research in Developmental Disabilities, 35, 408–413.

    Article  PubMed  Google Scholar 

  • LeCavalier, L., Leone, S., & Wiltz, J. (2006). The impact of behavior problems on caregiver stress in young people with autism spectrum disorders. Journal of Intellectual Disability Research, 50, 172–183.

    Article  PubMed  Google Scholar 

  • Mandell, D. (2008). Psychiatric hospitalization among children with autism spectrum disorders. Journal of Autism and Developmental Disorders, 38, 1059–1065.

    Article  PubMed  Google Scholar 

  • Mandell, D. S., Novak, M. M., & Zubritsky, C. (2005). Factors associated with age of diagnosis among children with autism spectrum disorders. Pediatrics, 116, 1480–1486.

    Article  PubMed  PubMed Central  Google Scholar 

  • McClintock, K., Hall, S., & Oliver, C. (2003). Risk markers associated with challenging behaviors in people with intellectual disabilities: A meta-analytic study. Journal of Intellectual Disability Research, 47, 405–416.

    Article  PubMed  Google Scholar 

  • McTierman, A., Leader, G., Healy, O., & Mannion, A. (2011). Analysis of risk factors and early predictors of challenging behavior for children with autism spectrum disorder. Research in Autism Spectrum Disorders, 5, 1215–1222.

    Article  Google Scholar 

  • Minshawi, N., Hurtwitz, S., Morriss, D., & McDougle, C. (2014a). Multidisciplinary assessment and treatment of self-injurious behaviors in autism spectrum disorder and intellectual disability: Integration of psychological and biological theory and approach. Journal of Autism and Developmental Disorders, 45, 1541–1568.

    Article  Google Scholar 

  • Minshawi, N., Hurwitz, S., Fodstad, J., Biebl, S., Morris, D., et al. (2014b). The association between self-injurious behaviors and autism spectrum disorders. Psychology Research and Behavior Management, 7, 125–136.

    Article  PubMed  PubMed Central  Google Scholar 

  • Murphy, O., Healy, O., & Leader, G. (2009). Risk factors for challenging behaviors among 157 children with autism spectrum disorders in Ireland. Research in Autism Spectrum Disorders, 3, 474–482.

    Article  Google Scholar 

  • Rattaz, C., Michelon, C., & Baghdadli, A. (2015). Symptom severity as a risk factor for self-injurious behaviours in adolescents with autism spectrum disorders. Journal of Intellectual Disability Research, 59, 730–741.

    Article  PubMed  Google Scholar 

  • Rice, C., Baio, J., Van Naarden Braun, K., Doernberg, N., Meaney, J. et al. (2007). A public health collaboration for the surveillance of autism spectrum disorders. Pediatric and Perinatal Epidemiology, 21, 179–190.

    Article  PubMed  Google Scholar 

  • Rice, C., Nicholas, J., Baio, J., Pettygrove, S., Lee, L. C., et al. (2010). Changes in autism spectrum disorder prevalence in 4 areas of the United States. Disability and Health Journal, 3, 186–201.

    Article  PubMed  Google Scholar 

  • Richards, C., Oliver, C., Nelson, L., & Moss, J. (2012). Self-injurious behaviors in individual with autism and intellectual disability. Journal of Intellectual Disability Research, 56, 476–489.

    Article  PubMed  Google Scholar 

  • Schroeder, S., Marquis, J. G., Reese, R. M., Richman, D., Mayo-Ortega, L., et al. (2014). Risk factors for self-injurious, aggression, stereotyped behavior among young children at risk for intellectual and developmental disabilities. American Journal on Intellectual and Developmental Disabilities, 119, 351–370.

    Article  PubMed  Google Scholar 

  • Sell, N. K., Giarelli, E., Blum, N., Hanlon, A., & Levy, S. (2012). A comparison of autism spectrum disorder DSM-IV criteria and associated features among African American and white children in Philadelphia county. Disability and Health Journal, 5, 9–17.

    Article  PubMed  Google Scholar 

  • Weiss, J. (2002). Self-injurious behaviors in autism: A literature review. Journal on Developmental Disabilities, 9, 129–143.

    Google Scholar 

  • Wiggins, L., Baio, J., Schieve, L., Lee, L. C., Nicholas, J. et al. (2012). Retention of autism spectrum diagnoses by community professionals: Findings from the autism and developmental disabilities monitoring network, 2000, 2006. Journal of Developmental and Behavioral Pediatrics, 33, 387–395.

    Article  PubMed  PubMed Central  Google Scholar 

  • Wolkewitz, M., Bruckner, T., & Schumacher, M. (2007). Accurate variance estimation for prevalence ratios. Methods of Information in Medicine, 46, 567–571.

    PubMed  Google Scholar 

  • Zou, G. (2004). A modified Poisson regression approach to prospective studies with binary data. American Journal of Epidemiology, 159, 702–706.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

We acknowledge CDC ADDM project personnel, ADDM projects coordinators, clinician reviewers, abstractors, data managers, and ADDM investigators at each site who contributed to the ADDM surveillance project and data collection.

Authors Contribution

Dr. Soke developed the initial proposal of the study, analyzed the data, and wrote the first manuscript. Drs. DiGuiseppi, Rosenberg, Robinson, Hamman, and Fingerlin participated in developing the initial proposal of the study and reviewed the manuscript. Drs. Lee, Carpenter, Durkin, and Wiggins reviewed the manuscript.

Author information

Authors and Affiliations

  1. Department of Epidemiology, Colorado School of Public Heath, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, USA

    Gnakub N. Soke, Richard F. Hamman, Tasha Fingerlin & Carolyn DiGuiseppi

  2. Department of Psychiatry, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, USA

    Steven A. Rosenberg & Cordelia Robinson

  3. Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, USA

    Cordelia Robinson

  4. Department of Pediatrics, Medical University of South Carolina, Charleston, SC, 29425, USA

    Laura Carpenter

  5. College of Nursing and Health Professions, Drexel University, Philadelphia, PA, 19102, USA

    Ellen Giarelli

  6. Departments of Epidemiology and Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA

    Li-Ching Lee

  7. National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, 30333, USA

    Lisa D. Wiggins

  8. University of Wisconsin School of Medicine and Public Health, Madison, WI, 53726, USA

    Maureen S. Durkin

Authors
  1. Gnakub N. Soke
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Steven A. Rosenberg
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Richard F. Hamman
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Tasha Fingerlin
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Cordelia Robinson
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Laura Carpenter
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Ellen Giarelli
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Li-Ching Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Lisa D. Wiggins
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Maureen S. Durkin
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Carolyn DiGuiseppi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Gnakub N. Soke.

Ethics declarations

Ethical Approval

All procedures performed in studies involving human participants were in accordance with ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study is a secondary data analysis of unidentified data previously collected in a surveillance system. Therefore, formal consent is not required.

Conflict of interest

All authors reported no conflicts of interest.

Additional information

Disclaimer The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Soke, G.N., Rosenberg, S.A., Hamman, R.F. et al. Brief Report: Prevalence of Self-injurious Behaviors among Children with Autism Spectrum Disorder—A Population-Based Study. J Autism Dev Disord 46, 3607–3614 (2016). https://doi.org/10.1007/s10803-016-2879-1

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10803-016-2879-1

Keywords

Search

Navigation